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Employment

Employment

Leisure Homestead Association

Join Our Team

If you’re interested in a career where you can care for and look after others, Leisure Homestead Association is always looking for good people to join our team. Please fill out and submit our employment form (see below).

Thank you for your interest in working at Leisure Homestead Association. Please call if you have any questions.

Employment Application

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Field label

Applicant Information

Full Name:

Date:

Address:

City:

State:

Zip Code:

Phone:

Email:

Date Available:

Desired Salary:

Position Sought:

Are you a citizen of the United States?

Yes

No

If no, are you authorized to work in the United States?

Yes

No

Have you ever worked for this company?

Yes

No

If yes, when?

Have you ever been convicted of a felony?

Yes

No

If yes, explain:

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Education

High School:

Address:

From:

To:

Did you graduate?

Yes

No

Diploma:

College:

Address:

From:

To:

Did you graduate?

Yes

No

Degree:

Other

Address:

From:

To:

Did you graduate?

Yes

No

Degree:

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References

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Please list three professional references.

Full Name:

Relationship

Company:

Phone:

Address:

Full Name:

Relationship:

Company:

Phone:

Address:

Full Name:

Relationship:

Company:

Phone:

Address:

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Previous Employment

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

No

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

No

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

No

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Disclaimer and Signature

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I certify that my answers are true and complete to the best of my knowledge.

If this applications leads to employment, I understand that false or misleading information in my application or interview may results in my relsease.

Signature:

Date:

Upload Your Resume:

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

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Contact Us

(620) 234-5208

Office Hours

Mon - Fri: 8:00 am - 4:00 pm
Sat - Sun: Closed

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